Individual provider Active NPI

Elizabeth Ann Rainville, PA-C

  • Medical Physician Assistant
  • Radnor, PA
National Provider Identifier
1710010137
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA003572L Issued in PA
Practice address
250 King of Prussia Rd Ste 2J
Radnor, PA 19087-5235
Phone
(610) 902-2450
Fax
(610) 902-2466
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA003572L PA Primary

Addresses

Primary practice location

250 King of Prussia Rd Ste 2J
Radnor, PA 19087-5235

Mailing address

250 King of Prussia Rd Ste 2J
Radnor, PA 19087-5235
Phone (610) 902-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080226000381 PA Practitioner - Physician Assistant 0749364065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

145 King of Prussia Rd 301
Adolescentand Yng Adult Med
Radnor, PA 19087-4557
Phone (610) 902-2450

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA003572LPAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Dec 22, 2018 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Dec 22, 2018 Accepting new patients

Locations

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

250 King of Prussia Rd
Ste 2J
Radnor, PA 19087
Phone (610) 902-2450

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1710010137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD STE 2J",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875235",
            "telephone_number": "610-902-2450",
            "fax_number": "610-902-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD STE 2J",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875235",
            "telephone_number": "610-902-2450",
            "fax_number": "610-902-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINVILLE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA003572L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Radnor, PA

Sources for this page

Verify at the official NPI Registry.